Lumbosacral transitional vertebrae: association with low back pain

Radiology. 2012 Nov;265(2):497-503. doi: 10.1148/radiol.12112747. Epub 2012 Sep 5.

Abstract

Purpose: To assess the prevalence and degree of lumbosacral transitional vertebrae (LSTV) in the Osteoarthritis Initiative (OAI) cohort, to assess whether LSTV correlates with low back pain (LBP) and buttock pain, and to assess the reproducibility of grading LSTV.

Materials & methods: Institutional review board approval was obtained, and informed consent documentation was approved for the study protocol. Standard standing pelvic radiographs that included the transverse processes of L5 were graded according to Castellvi classification of LSTV in 4636 participants (1992 men and 2804 women; aged 45-80 years) from the OAI cohort. These data were correlated with prevalence and severity of LBP and buttock pain.

Results: Prevalence of LSTV was 18.1% (841 of 4636), with a higher rate in men than in women (28.1% vs 11.1%, respectively; P<.001). Of the 841 individuals with LSTV, 41.72% were type I (dysplastic enlarged transverse process), 41.4% were type II (pseudoarticulation), 11.5% were type III (fusion), and 5.2% were type IV (one transverse process fused and one with pseudoarticulation). Of the participants without LSTV, 53.9% reported LBP, while the prevalence of LBP for types I, II, III, and IV was 46%, 73%, 40%, and 66%, respectively (P<.05, χ2 test). Types II and IV had higher prevalence and severity of LBP and buttock pain (P<.001).

Conclusion: LSTV types II and IV positively correlate with prevalence and severity of LBP and buttock pain.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Abnormalities, Multiple
  • Aged
  • California / epidemiology
  • Comorbidity
  • Congenital Abnormalities / diagnostic imaging
  • Congenital Abnormalities / epidemiology*
  • Female
  • Humans
  • Low Back Pain / diagnosis
  • Low Back Pain / epidemiology*
  • Male
  • Meningocele
  • Middle Aged
  • Osteoarthritis, Knee / diagnostic imaging
  • Osteoarthritis, Knee / epidemiology*
  • Prevalence
  • Radiography
  • Risk Factors
  • Sacrococcygeal Region / abnormalities
  • Sacrococcygeal Region / diagnostic imaging
  • Sex Distribution

Supplementary concepts

  • Sacral defect and anterior sacral meningocele